Healthcare Provider Details

I. General information

NPI: 1982945853
Provider Name (Legal Business Name): OSMAN NASR SOLIMAN BDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2013
Last Update Date: 05/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 W 34TH ST DEN124C
LOS ANGELES CA
90089-0058
US

IV. Provider business mailing address

925 W 34TH ST DEN124C
LOS ANGELES CA
90089-0058
US

V. Phone/Fax

Practice location:
  • Phone: 213-740-0655
  • Fax:
Mailing address:
  • Phone: 213-740-0655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number28944
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: